Cosmetics and Blepharitis – A Two Part Series

In part one of a two-part series, Sarah Darbandi, MD discusses the effects of cosmetics on the eyes, particularly for patients with dry eye and blepharitis.

Q: How are cosmetics harmful to the eyes, particularly for patients with dry eye or blepharitis?

There are many things we apply around our eyes and on our eyelids, which is the thinnest skin on our body, including cleanser, moisturizer, under eye cream, concealer, eye shadow, mascara, eyeliners and more. Many of these products contain wax (synthetic, paraffin or beeswax) as well as potentially toxic chemicals such as carcinogens and parabens. Although parabens prevent the growth of bacteria in makeup, they can be absorbed through the skin and transmitted into the bloodstream. Parabens can also make dry eye worse as they prohibit the oil glands that line the eyelid from secreting enough oil.

Q: Why is makeup even more harmful to patients with dry eye and blepharitis?

A: There are many chemicals in makeup that can be toxic and even more so for people with dry eye or blepharitis who already have sensitive eyes and may be undergoing treatment. It’s one more thing that may not be good for them and add to their misery. I try to encourage these patients to take a break from makeup particularly while being treated. And when patients do start wearing makeup again, I encourage them to choose brands that are formulated without some of the more synthetic parabens and waxes.

Q: Are there particular makeup techniques that can be harmful to your eyes?

A: There are new techniques for applying makeup that can be harmful to your eyes. Tight lining is when you apply eyeliner directly over the water line and oil glands. Eyeliners typically have parabens, synthetic wax, or bee’s wax, which can block the oil glands. For someone with dry eye or blepharitis, who already has inflammation, this can make the oil glands clog and allow particles of makeup to migrate into the tear film. Mascara and other gel products also have a lot of wax that can have the same affect.

Another technique called baking is when you apply cream under eye concealer then lay translucent powder over it. This gets rid of all the creases and looks amazing, but when you then put drops in your eyes, the powders can get into the tear film and cause burning, stinging, and tearing. This can also cause more inflammation and affect tear osmolarity. I’ve also seen tattooing of the conjunctiva where patients have worn makeup for so long, it’s gotten underneath the mucus layer and becomes tattooed there.

Q: What can patients do to help protect their eyes when wearing makeup?

A: I’m a big fan of primers that make powders stick, particularly those with sunscreen. This helps the eye makeup stay in place so it doesn’t migrate and get into the tear film. There are also permanent makeup options, including eyeliner that is applied to the skin outside of the lid margin. Its iron oxide pigments are safe and there is no migration of pigments to the glands. However, since the application may cause some swelling, I don’t recommend this for patients with active inflammation.

Q: Are there any other key points about cosmetics you would like to make?

A: There are many patients I see who are undergoing treatment and really should not be wearing makeup. However, this can be hard to do as we as our society that has become addicted to makeup. It’s fun and makes us feel good, but for dry eye and blepharitis sufferers it can be harmful and hamper recovery. It’s all about stopping the inflammation. So just as I tell contact lens wearers to stop using contacts when they have an infection, I tell patients to hold off on makeup for a while until their eyes heal. Then I encourage them to try more natural brands with fewer chemicals.

To learn more ocular surface disease and blepharitis, download the Achieve Optimal Ocular Hygiene with Cliradex for the Eyelids, Lash and the Face infographic by clicking the button below.

In part two of her series, Sarah Darbandi, MD will discuss the role of cosmetics in Demodex and the importance of daily ocular hygiene.

Sarah Darbandi, MD attended Medical School at West Virginia University, then went on to residency in Ophthalmology at the West Virginia University Eye Institute. With her interest in corneal transplantation and refractive surgery, she completed a fellowship in Albany, New York in Cornea and Refractive Surgery. Dr. Darbandi practices at Bowden Eye & Associates in Jacksonville, FL.